Otoscopes have long been a staple device in the physician's office as a tool for visually examining the ear. A typical otoscope, such as those manufactured by Heine Inc. and Welch Allyn, Inc., among others, includes a handle that may house a battery, and an instrument head mounted to the top of the handle. A conical speculum portion at a distal end of the instrument head permits insertion thereof a predetermined distance into the ear canal of a patient. An image is seen by the user through means of a magnifying eyepiece located on the rear or proximal side of the instrument, with the ear being illuminated by means of an interior lamp or a lamp tethered to a bundle of optical fibers located in the instrument head to facilitate viewing.
Other otoscopic instrument versions have since been developed which include a video camera that is attached to the eyepiece portion of the instrument head. An optical lens system, such as a relay lens assembly or a rod lens assembly, transmits the image directly to the camera. More recent versions employ a miniature imager element, such as a CCD, which is distally or otherwise positioned within the instrument head.
Otoscopes are typically used to allow a visual inspection of a patient's ear, and in particular, the patient's tympanic membrane. For example, acute otitis media (AOM), which is one of the most common ailments in children, can be classified as an infectious inflammation in the middle ear that typically starts abruptly with significant pain, is of relatively short duration and can be clinically verified (e.g., diagnosed) at least in part, by inspection of the tympanic membrane. Symptoms may include earache, fever and reddening and/or bulging of the tympanic membrane within the ear canal. Other ailments may also be suggested by visual inspection of the ear canal, including otitis media with effusion (Otitis Media with Effusion or OME), which may also present as bulging of the tympanic membrane; for example, a reddening and thickening of the tympanic membrane with a loss of normal topology may suggest AOM, OME, or a common cold virus. To an inexperienced observed, it may be difficult to diagnoses a problem with the tympanic membrane problems because there may be substantial visual overlap between the problems.
Thus, although the standard for medical diagnosis, and therefore medical treatment, may involve the use of an experience physician observing the patient's tympanic membrane, in some cases it may be difficult or overly costly for a patient, or (in the case of children) guardians/caregivers for patients, to timely visit a physician to have their ear examined directly by a physician or health care provider.
Thus, it may be desirable to provide tools, including in particular tools that may be used or incorporated into/onto a mobile computing device, such as a smartphone, pad, laptop computer, or the like, to act as an otoscope. In particular, it may also be useful to provide one or more tools and/or methods for guiding a subject (e.g., parent, caregiver, patient, health care provider, etc.) to acquire one or more images (including video) of the inner ear region, including or particularly including the tympanic membrane. Thus, these systems and methods may make it possible for untrained persons to take and save high-quality images of the tympanic membrane. In any of the variations described herein, the subject may also be the patient (e.g., they may be taking an image or images of their own ear).
It may also be useful to provide one or more methods and apparatuses for guiding the interpretation of one or more images of a subject's body (e.g., inner ear and/or tympanic membrane). For example, it would be helpful to provide one or more images of a patient's inner ear/tympanic membrane and provide similar images (including time course images) from a database of such images, particularly where the database images are associated with related images and/or diagnosis/prognosis information. It would also be helpful to identify a particular region (e.g., tympanic membrane) from an image, as well as provide methods and apparatuses for clarifying the images and preparing them for comparison to a database of similar images (for which one or more clinical identifiers may be associated).
Thus, described herein are methods and apparatuses (including devices and systems) for guiding taking of one or more images of a tympanic membrane, as well as analyzing the resulting image(s) and determining a diagnosis. In general these methods and apparatuses may identify a region of an image corresponding to a tympanic membrane, as well as presenting the image (e.g., along with similar images from a database).